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Abstract

Physician burnout finds its roots in both undergraduate and graduate medical education and has emerged as an important cause of academic faculty turnover. Recognition of the need for resiliency training has led to the development and implementation of wellness programmes throughout the country and world. This chapter examines the causes and potential solutions of combating resident physician and academic faculty burnout in medical education. The authors reviewed current literature on wellness programmes in medical education, including both traditional and curricular approaches and provide a template for creating a well-rounded wellness programme to promote resident physician and academic faculty wellness.

Background

When examining undergraduate medical education, two unique classifications of burnout predispositions have been studied: exogenous stressors and endogenous stressors. Exogenous or environmental stressors include ‘adjustment to medical school, student abuse, witnessing and unwillingly participating in unethical behaviour towards patients and exposure to death and suffering’ (Benbassat et al., 2011). Of note, the endogenous stressors were often related to qualities identified in one’s personality such as neuroticism and contentiousness.

People who chose the field of medicine are often concrete thinkers and interested scientists, looking for evidence to evaluate the strength of a concept. Incoming students are often not prepared for the uncertainty that lies within medicine, so students struggle with an ‘intolerance of uncertainty’ also known as a ‘perception of ambiguous situations as a threat’ often comes as an endogenous stressor. Three different types of uncertainty have been described in literature (Benbassat et al., 2011). The first and most common is an uncertainty of one’s personal adequacy; students were concerned that they would not learn all they needed to know to be a successful physician. This uncertainty can also be manifested in the competitiveness associated with undergraduate medical education, though newly addressed with curricular changes (Benbassat et al., 2011; Slavin, Schindler, & Chibnall, 2014). The other two uncertainties concerned the limitation of available medical knowledge and lastly, the uncertainty resulting from being unable to distinguish between the other two uncertainties (i.e. uncertainty of personal adequacy and limitation of one’s medical knowledge) (Benbassat et al., 2011).